Republic of the Philippines)

Baguio City )
x-------------------------------x

AFFIDAVIT

I, JESSY POLITO BENITO, of legal age, married, Filipino citizen and a resident of IB
81 Betag, La Trinidad, Benguet, under oath, depose and state, viz –

1. I was born on December 25, 1978;

2. My parents are spouses Mayo Benito and Melania Polito-Benito who got married in
1975 at La Trinidad, Benguet;

3. My first name is JESSY and my middle name is POLITO and I had been using the
name JESSY POLITO BENITO in all of my school records, employment records and all other
personal documents;

4. However, upon receipt of my Certificate of Live Birth in security papers issued by the
National Statistics Office (NSO) I noticed that my first name was “Baby boy” instead of Jessy
and my middle name is spelled as “Politu” instead of Polito;

5. I am executing this affidavit to attest to the truthfulness of the above narration of

facts and for purposes of supplementing the correction of my first name and middle name
which I filed with the National Statistics Office and for all other intents and purposes that this
affidavit may serve.

Affiant further says none.

IN WITNESS WHEREOF, I hereunto set my hand this 7th day of December 2010 at
Baguio City, Philippines.

JESSY P. BENITO
Postal ID No. 6724225
Issued by the
Postal Administration of the Philippines

SUBSCRIBED and SWORN to before me at Baguio City, Philippines this 7 th day of

December, 2010 by the above affiant who is personally known and identified by me upon
presentment of his Postal ID card be the same person who freely and voluntarily executed the
above affidavit.

WITNESS MY HAND AND SEAL

Doc. No. ___; MILTON L. BALAGTEY

Page No. ___; NOTARY PUBLIC
Book No. XX; until December 31, 2011
Series of 2010 PTR No. 2657119; 01-08-10; B.C
IBP No. 806002; 01-08-10; B.C